Anaesthesia and Intensive Care最新文献_第3页

Survey of administration of intravenous ketamine for perioperative pain management in Australia and New Zealand.

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-12 DOI: 10.1177/0310057X241309655

Patryck J Lloyd-Donald, Philip J Peyton

{"title":"Survey of administration of intravenous ketamine for perioperative pain management in Australia and New Zealand.","authors":"Patryck J Lloyd-Donald, Philip J Peyton","doi":"10.1177/0310057X241309655","DOIUrl":"https://doi.org/10.1177/0310057X241309655","url":null,"abstract":"Ketamine is an N-methyl-d-aspartate receptor antagonist approved for use in anaesthesia, with analgesic properties. Despite publication of numerous trials and expert guidelines on its use for pain management, administration of ketamine as part of multimodal perioperative analgesia remains 'off-label'. We conducted an online, prospective survey of ANZCA Fellows, exploring current prescribing practices of intravenous ketamine for perioperative analgesia. We surveyed 2000 Fellows and received 806 responses. The factors mostly likely to influence their administration of perioperative ketamine included pre-existing chronic pain, and heavy or multiple opioid use by patients preoperatively. Amongst respondents, less senior anaesthetists and those working in public hospitals were more likely to administer intraoperative ketamine. The surgical procedures most likely to result in ketamine administration intraoperatively were open pelvic/abdominal, thoracic and major spinal surgery, where ketamine administration was likely practice for the majority of respondents, with typical loading doses that ranged widely. The commonest choices of intraoperative loading dose were between 0.2 mg kg-1 and 0.6 mg kg-1. The commonest choice of intraoperative and postoperative infusion rate was in the range of 0.1-0.2 mg kg-1 h-1. Postoperative ketamine infusion was most commonly prescribed as third-line or rescue analgesia. The majority of respondents thought it either 'likely' or 'very likely' ketamine would reduce postoperative chronic pain after thoracic surgery, but not in other surgical categories. Our findings suggest that off-label perioperative administration of ketamine at analgesic dose ranges is routine or common practice in major surgery for a majority of specialist anaesthetists in Australia and New Zealand.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241309655"},"PeriodicalIF":1.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Awards for papers published in Anaesthesia and Intensive Care, 2023.

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-11 DOI: 10.1177/0310057X241298852

John A Loadsman, Michael G Cooper

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Unrecognised drug error and subsequent airway management utilising ultrasound-guided cricothyroidotomy and Rapid-O2® oxygen insufflation.

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-11 DOI: 10.1177/0310057X241304426

Patrick Wong, Emma E Foster, Julian B White

引用次数: 0

Expert opinions on the applicability of the European guidelines on postoperative delirium in Australia and New Zealand. 关于欧洲术后谵妄指南在澳大利亚和新西兰的适用性的专家意见。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-11 DOI: 10.1177/0310057X241300166

Neil L Pillinger, Robert D Sanders

引用次数: 0

The impact of the introduction of monitored anaesthesia care in the cardiac catheterisation laboratory on Clinical Review, Rapid Response, and Blue Code rates, and mortality.

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-11 DOI: 10.1177/0310057X241304423

Sophie A Meyerson, Ben Olesnicky, Gene Lee, Andrea S Santoro, Ravinay Bhindi

{"title":"The impact of the introduction of monitored anaesthesia care in the cardiac catheterisation laboratory on Clinical Review, Rapid Response, and Blue Code rates, and mortality.","authors":"Sophie A Meyerson, Ben Olesnicky, Gene Lee, Andrea S Santoro, Ravinay Bhindi","doi":"10.1177/0310057X241304423","DOIUrl":"https://doi.org/10.1177/0310057X241304423","url":null,"abstract":"Most procedures in cardiac catheterisation laboratories (CCLs) have traditionally been performed under conscious sedation under the supervision of the treating proceduralist. With growing demand for more complex procedures to be performed, in emergencies and in patients with limited cardiorespiratory reserve, a reconsideration of the level of supervision provided is required. We conducted a retrospective cohort study of all patients who had CCL procedures and required an overnight stay at Royal North Shore Hospital during a 12-month period prior to introducing monitored anaesthesia care (MAC), compared with a 12-month period following introduction of MAC on selected weekdays. Primary outcomes were the difference in rates of Code Blue calls (triggering the cardiac arrest team), Clinical Reviews and Rapid Responses (defined as per the NSW Health 'Between the Flags' Deteriorating Patient Safety Net System) in the 24 h post-procedure between patients who did and did not have MAC. The secondary outcome was a difference in mortality (within 24 h of a procedure and in-hospital) between patients who did and did not have MAC. One thousand nine hundred and eight patients were analysed (926 pre-intervention, 982 post-intervention). We found no statistically significant difference in any of the primary or secondary outcomes between the pre-intervention and post-intervention patients overall. However, we found a statistically significant lower rate of Code Blue calls in patients who had MAC (n = 3, 0.6%) compared with no MAC (n = 31, 2.3%). We also found a significantly lower 24-h mortality in patients who had MAC (n = 1, 0.2%) compared with no MAC (n = 22, 1.6%), but no difference in overall in-hospital mortality.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241304423"},"PeriodicalIF":1.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A randomised trial to assess the impact of midodrine on early mobilisation after elective primary hip replacement surgery.

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-08 DOI: 10.1177/0310057X241290536

Adam C Cammerman, Daniel Wl Haslam, Dale A Currigan, Mark J Lennon

{"title":"A randomised trial to assess the impact of midodrine on early mobilisation after elective primary hip replacement surgery.","authors":"Adam C Cammerman, Daniel Wl Haslam, Dale A Currigan, Mark J Lennon","doi":"10.1177/0310057X241290536","DOIUrl":"https://doi.org/10.1177/0310057X241290536","url":null,"abstract":"Early mobilisation following elective total hip arthroplasty (THA) facilitates quicker rehabilitation, and reduces complications and hospital length of stay. Reasons for delayed mobilisation are multifactorial, but the most common cause is orthostatic intolerance. Midodrine, an oral alpha-1 agonist, is used off-label for perioperative hypotension. However, there are few randomised trials assessing its use in the perioperative setting to improve patient outcomes. The aim of the study was to determine whether midodrine improves early mobilisation following primary THA, and whether this relates to reduced orthostatic intolerance. This prospective, triple-blinded, multicentre study involved 42 patients randomised to either placebo or 20 mg midodrine, 2 h before physiotherapy, on Day 1 postoperatively. The inclusion criteria were adults undergoing elective unilateral THA under spinal anaesthesia. The primary endpoint was the ability to walk 5 m with physiotherapists. Secondary endpoints included the incidence of orthostatic intolerance and hypotension. A preplanned interim analysis showed no statistical difference in ability to mobilise 5 m (78.26% vs 78.95%, P = 1.0). There was no statistically significant difference in the incidence of orthostatic intolerance between the groups 17.4% vs 31.6% (P = 0.45). Pre-emptive use of midodrine did not improve patient mobilisation the morning after elective primary THA and had no significant effect on the incidence of orthostatic hypotension.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241290536"},"PeriodicalIF":1.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative anaphylaxis in Malaysia: A nine-year retrospective study.

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-04 DOI: 10.1177/0310057X241284655

Fan-Yin Kwok, Mun-Tsong Hui, Cindy Thomas Joseph, Arfah Hanim Binti Mohamad, Mohammed-Faizal Bakhtiar

{"title":"Perioperative anaphylaxis in Malaysia: A nine-year retrospective study.","authors":"Fan-Yin Kwok, Mun-Tsong Hui, Cindy Thomas Joseph, Arfah Hanim Binti Mohamad, Mohammed-Faizal Bakhtiar","doi":"10.1177/0310057X241284655","DOIUrl":"https://doi.org/10.1177/0310057X241284655","url":null,"abstract":"Diagnosis of perioperative anaphylaxis (POA) and identification of causative agents remain challenging. This study aimed to describe the estimated incidence, characteristics and causative agents of POA in Malaysia. This is a retrospective review of all cases of suspected POA referred to the only anaesthetic allergy centre in Malaysia from March 2014 to December 2022. One hundred and ninety patients with suspected POA of Grade 2 and above were included. Data on clinical presentation, severity, management, serum tryptase and subsequent allergy workup (including skin and serum testing results) of these patients were extracted from the database. Dynamic tryptase was elevated in half of the cases where tryptase results were available and skin tests were positive in 96% of these cases. Skin testing was positive in 113 patients (60%) overall, and more than 70% of Grades 3 and 4 anaphylaxis cases. Neuromuscular blocking agents (NMBAs) and antibiotics were the most commonly identified causative agents (27.4% and 23% respectively). The commonest NMBAs were rocuronium and atracurium, both commonly cross-reacting with cisatracurium. The overall cross-reactivity rate among NMBAs was 58%. For antibiotics, the commonest causative agents were cefuroxime, ceftriaxone and amoxicillin/clavulanic acid. Using these data, the estimated incidence of Grades 2-4 POA over this period in Malaysia was approximately 1 in 30,000 anaesthetics. However, owing to the voluntary nature of reporting, it is possible that this is an underestimate, particularly in relation to some milder Grade 2 cases which may have gone unrecognised or unreported.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241284655"},"PeriodicalIF":1.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The elective use of percutaneous transtracheal oxygen insufflation for laryngeal surgery in a patient with a known difficult airway.

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-04 DOI: 10.1177/0310057X241285921

Matthew J Bolland, David T Andrews, Daryl L Williams

引用次数: 0

The Bruck inhaler: An ether inhaler misattributed to Ludwig Bruck, an Australian medical publisher and supplier of medical equipment.

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-01-27 DOI: 10.1177/0310057X241285171

Rajesh P Haridas, Michael G Cooper, Andrew J Kennedy

{"title":"The Bruck inhaler: An ether inhaler misattributed to Ludwig Bruck, an Australian medical publisher and supplier of medical equipment.","authors":"Rajesh P Haridas, Michael G Cooper, Andrew J Kennedy","doi":"10.1177/0310057X241285171","DOIUrl":"https://doi.org/10.1177/0310057X241285171","url":null,"abstract":"The acquisition of an early ether inhaler stimulated research into several inhalers classified as Bruck inhalers. Ludwig Hermann Bruck was a German migrant who arrived in Australia in 1873. He became a medical publisher, importer of medical instruments, and made unique contributions to early Australian medical publishing, most significantly as the first publisher of The Australasian Medical Gazette. He also published The Australian Medical Directory and Handbook which contained lists of unregistered medical practitioners and alternative therapists. In 1914, Bruck joined in business with Richard Thomson who had a company selling medical equipment to doctors and hospitals. During the First World War, both Bruck and Thomson were charged with trading with the enemy. Bruck committed suicide in August 1915 before the case was heard in court. We did not find any evidence that Bruck designed the inhaler later attributed to him. The Bruck inhaler is functionally similar to the Probyn-Williams inhaler and should therefore be regarded as a glass-domed version of this inhaler.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241285171"},"PeriodicalIF":1.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Documentation of informed consent for anaesthesia: A single-site retrospective audit at a rural Australian hospital. 麻醉知情同意文件：澳大利亚农村医院单点回顾性审计。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-01-06 DOI: 10.1177/0310057X241281364

Yannick J De Silva, Luke Anderson

引用次数: 0